%0 Journal Article
%T Optimized Antiretroviral Therapy with Darunavir/Ritonavir, Etravirine and/or Raltegarvir: A Salvage Therapy Option in HIV-1 Infected Patients with Long-Term Therapeutic Failures, about 23 Cases
%A Vincent Guiyedi
%A Olivier Mounoury
%A Soraya Boucherit
%A Pascale Longuet
%A C. Brunet-Fran？ois
%A Eric Kendjo
%A J. L. Ecobichon
%A Madeleine Okome-Nkoumou
%A Catherine Leport
%A F. Raffi
%J World Journal of AIDS
%P 300-305
%@ 2160-8822
%D 2012
%I Scientific Research Publishing
%R 10.4236/wja.2012.24040
%X Objectives: The aims of this study was to analyze the immuno-virologic response after optimised background antiretroviral therapy (OBT) associated to new active antiretroviral treatment (ART) in HIV-1 infected patients with chronic virologic failure. Methods: We conducted a descriptive analysis of the immuno-virologic responses in HIV-1 adult infected patients: 1) harbouring multiple therapeutic failures with ART; 2) with no virologic response obtained over 10 years (1997-2008); and 3) treated with OBT combined with new drugs including at least 1 of the 3 active ART among darunavir/ritonavir, etravirine and raltegravir; 4) observed between month 0 (M0), before new ART to month 12 (M12) after new ART initialisation. Results: Twenty three patients were included in the study. After OBT, the proportion of patients with undetectable viral load was significantly higher at M6 and M12 than M0 (86% and 73% versus 0%, p = 0.03, respectively). At the same period, the median HIV viral load decreased significantly in 19/23 (83%) patients from 4.3 to 1.69log<sub>10</sub> HIV-1 RNA copies/ml (p &lt; 0.001, respectively). The median CD4-T cells count increased significantly from 171/mm<sup>3</sup> [0 - 604] to 449/mm<sup>3</sup> [130 - 964] between M0 and M12 (p &lt; 0.001), while the proportion of patients with CD4-T cells count below 200/mm<sup>3</sup> decreased from 57% to 23% (p = 0.02). Tolerability was good and no death was recorded during the 12-month' follow-up. Conclusions: These results show that the combination of OBT with the new ART can offer a salvage therapy in patients presenting a long-term history of virologic failures.
%K Darunavir/Ritonavir
%K Etravirine
%K Raltegravir
%K HIV-1
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=25327